Healthcare Information Systems (HIS)

by Rhonda Lawes, PhD, RN

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    00:01 Hello, future healthcare informatics! Today, we're taking a deeper dive into the backbone of the healthcare world - the healthcare information systems (HIS).

    00:11 These systems are our behind-the-scenes maestros, ensuring everything in healthcare is orchestrated perfectly.

    00:19 So buckle up, and let's explore! HIS are critical tools in modern healthcare, used to manage and store patient data.

    00:28 They improve healthcare delivery by making patient medical history easily accessible to all providers involved in a patient's care.

    00:35 There are many types of HIS, but let's focus on four major categories: Hospital Information Systems (HIS) These are the systems that we use to tell us how many empty or full beds we have.

    00:50 Now, consider how useful this information is in a mass disaster or pandemic.

    00:56 These systems can tell state, national, and international stakeholders how much capacity a region has for treating patients.

    01:04 Electronic Health Records (EHR) are the systems that store patient medical data, now this can be anything including medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory test results.

    01:20 Now here is a great place to think about the influence of an informatics professional.

    01:25 Most EHRs are built with an option to enter physical assessment data.

    01:29 Some are designed with a separate form to complete a psychological assessment.

    01:34 What about in the situations where a client needs both? The healthcare informaticist professional is the person to say - hey! Let’s avoid double, triple and quadruple charting on multiple screens for multiple reasons. Leveraging knowledge of software development, the informaticist can suggest solutions like autofill features, or layering of forms for data entered by the same provider at a set time. Practice Management Software (PMS): These systems handle the day-to-day operations of medical practices, like scheduling appointments and managing billing.

    02:06 This technology maximizes the efficiency of the comprehensive healthcare team.

    02:11 Now it does this by automating information such as how much each test or lab costs, so this saves data entry time and generate bills and track payments.

    02:22 Laboratory Information Systems (LIS): manage data in a clinical laboratory, like tracking and processing samples and generating reports.

    02:29 Consider how useful it is for a clinical lab to be able to run a report that shows them all the abnormal values for a particular machine against other machines in the lab.

    02:39 These kinds of reports are useful in seeing the big picture of trends and help figure out how reliable and valid lab results are for the whole lab, not just one patient at a time.

    02:50 Now, let's talk about how these systems interact with each other.

    02:53 The magic word here is 'Interoperability' - the ability of different HIS to communicate, exchange data, and use the information that has been exchanged.

    03:03 For instance, a patient's data can move from a hospital's EHR to a specialist's PMS, ensuring seamless care.

    03:11 Interoperability is enabled by a set of standardized coding systems, which allow HIS to talk the same language.

    03:18 To understand this better, let’s begin with an example.

    03:22 Imagine trying to order a pizza in a foreign country without knowing the language.

    03:26 Frustrating, right? That's where standardized nomenclatures come in.

    03:31 They're like the agreed language or code that healthcare systems use to chat with each other. Let's start by introducing you to a major player in this arena, SNOMED CT, now that stands for Systematized Nomenclature of Medical Clinical Terms.

    03:47 Think of SNOMED CT as a medical dictionary that's universally understood.

    03:52 So, if a doctor in Los Angeles wants to share medical records with a specialist in New York, they can both 'speak SNOMED CT'.

    04:00 It ensures they can communicate clearly about the patient's condition, treatments, and more, which means no misunderstandings and better patient care.

    04:11 In SNOMED CT, each unique medical term, or 'concept', is assigned an identification number, known as a 'concept ID'.

    04:19 For instance, the 'concept ID' for 'open fracture of tibia' could be 193817009. Also, each concept might have different descriptions, but they'll all link back to the same 'concept ID'.

    04:35 How is this helpful? Well, because even if one hospital uses the term "open fracture of tibia" and another uses the term "open tibial fracture," the data transfer should still work seamlessly. This is because both labs use the same language (SNOMED CT), which assigns the same code to both terms.

    04:56 This smart system allows for precise communication and understanding across the entire healthcare spectrum, so no matter where or with whom you're communicating, it's as straightforward as ordering your favorite pizza.

    05:09 Next, we have LOINC, the Logical Observation Identifiers Names and Codes.

    05:15 Let's say a patient gets their blood work done in two different labs.

    05:18 LOINC works similtar to SNOMED CT.

    05:21 It helps healthcare professionals label these results uniformly so that, irrespective of the lab, doctors and nurses can interpret and compare them easily.

    05:31 So, simply put, LOINC is often used for laboratory tests and observations.

    05:36 So, even if one lab abbreviates "Hemoglobin" as "Hb" and another lab uses the full name, the data transfer should still work seamlessly because both labs use the same language. LOINC assigns the same code (for example “718-7”) to both terms.

    05:54 The last coding system in our list is the ICD-10, the International Classification of Diseases, 10th Revision.

    06:02 This one follows the same logic as the previous ones with the difference that ICD-10 is used primarily for morbidity and mortality reporting and billing.

    06:12 ICD-10 classifies diseases, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease.

    06:21 It is widely used in hospitals and healthcare facilities for disease reporting and statistical purposes, and in any scenario where it is necessary to code a diagnosis or cause of death. So, ICD-10 codes help healthcare professionals identify relevant medical cases, aiding in research and policy decisions.

    06:41 So, let’s quickly summarize this.

    06:43 In terms of differences, ICD-10 is more focused on diagnosis coding for billing purposes, while SNOMED CT is broader and more detailed, and it’s suitable for clinical notes and procedures in electronic health records.

    06:56 LOINC, on the other hand, is focused on laboratory and other observational data.

    07:02 So, while they might overlap to a certain extent, each of these coding systems has its unique purpose and usage in healthcare.

    About the Lecture

    The lecture Healthcare Information Systems (HIS) by Rhonda Lawes, PhD, RN is from the course Healthcare Informatics.

    Included Quiz Questions

    1. Logical Observation Identifiers Names and Codes (LOINC)
    2. Systemized Nomenclature of Medicine-Clinical Terms (SNOMED CT)
    3. International Classification of Diseases, 10th Revision (ICD-10)
    4. International Institute for Health Information Codes (IIHIC)
    1. A doctor can understand the documentation of another health care provider even though they used different terminology, as the terms had the same concept ID.
    2. A lab technician can see that a client got lab tests in a lab across the country, as the client had the same ID number in both states.
    3. A nurse practitioner can assign a unique code to a client with multiple medical diagnoses for billing purposes.
    4. A nurse can describe a procedure to a client using medical terminology only to improve the client’s health literacy.
    1. A computer program that shows the number of empty beds a hospital has.
    2. Electronic health records.
    3. An electronic program that shows lab results.
    4. An offline spreadsheet of client phone numbers.
    5. A point-of-care lab test machine that gives results in real-time and is not connected to any network.

    Author of lecture Healthcare Information Systems (HIS)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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